Type of publication:
Conference abstract
Author(s):
Chopra S.; Kaur H.; *Chai A.; *Sahu B.
Citation:
BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BGCS 2026 Book of Abstracts. Bristol United Kingdom. 133(Supplement 2) (pp S25), 2026. Date of Publication: 01 Jun 2026.
Abstract:
Background: Management of unscheduled bleeding on HRT is an integral part of investigating endometrial cancer, due to the increasing referrals to the Urgent Suspicion of Cancer Pathway (USCP). Objective(s): We aimed to retrospectively assess the impact that this pathway will have on our clinical practice. Method(s): Patients referred to the gynaecology cancer services at Shrewsbury and Telford Hospitals (SaTH) between March and October 2024 were retrospectively included. Under the BMS 2024 guidelines, data was extracted, including but not limited to demographics, time since menopause, HRT duration, parity, cancer risk factors, and amendment status during primary care. The recorded biopsy results served as the outcome. Result(s): Of the 1308 referrals identified, 627 (47.9%) were referred while actively using HRT. The rate of endometrial cancer diagnosis was significantly lower in the HRT cohort (0.15% (1/627)) when compared to the non-HRT cohort (4.55% (31/681)). Age was not included as a major risk factor, despite higher predictive value for uterine cancer in women over 55. The BMS pathway, although designed primarily for use in primary care, was complex and difficult to apply within a standard 10-min GP consultation when identifying patients requiring secondary care referral. Conclusion(s): We developed a simplified modified pathway to support our GP colleagues. We incorporated age as an additional risk factor and tailored the pathway to reflect best practice and the needs of our local population. The success of this initiative may support the development and adoption of similar pathways in other services.
DOI: 10.1111/1471-0528.70281
